[Karan]

Above normal kappa-lambda FLC ratio - meaning?

by Karan on Tue Jan 06, 2015 11:10 am

Hi guys,

My mother is suffering from multiple myeloma stage 3. She has taken 12 week chemotherapy and from the last 6 month she is taking lenadomide [Revlimid] as continued medication.

Today we have given her blood sample for kappa lambda chain ratio checking and other haematology analysis. What we found is she has a hike in kappa lambda ratio of 2.896 (normal range is up to 1.6).

Can you please let me know any way to reduce this? And what is the progression status? I mean, is it so fast, or is it regular?

[Ron Harvot]

Re: Above normal kappa-lambda FLC ratio - meaning?

by Ron Harvot on Tue Jan 06, 2015 2:59 pm

Its hard to say what the serum free light chain assay (sFLC) ratio test is telling you. Yes, the ratio is high, but if she was stage 3, it is very possible that it was much higher 12 weeks ago. So it is very possible that the recent test results are actually showing progress. The ratio of 2.89 is not extremely high, so in and of itself does not tell much.

To determine if the treatment is working, you would need the full tests results since her diag­nosis, including her serum protein electophoresis (SPEP) and immunofixation electro­phoresis (IE). Those tests will tell the type of abnormal protein and size M spike [m-protein, paraprotein, monoclonal protein] she has. The sFLC test will identify which light chain is being over produced (kappa or lambda), as well as the ratio.

If you have all of the results since diagnosis, you can see if progress is being made. The M spike should be declining, the over produced light chain should be lowering, and the ratio improving.

In addition, they probably did a bone scan to determine the extent of lesions, and a bone marrow biopsy that will tell the % of the marrow that was impacted by the myeloma cells.

Ron